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- December 1, 2016
Fact Sheet: Utilization Controls for Medicaid Prescription Drugs
Abbi Coursolle and Andy DiAntonio Manual/ReportRead moreState Medicaid programs that elect to provide outpatient prescription drug coverage must cover all FDA-approved drugs that are offered by a manufacturer that agrees to provide rebates. Nevertheless, states have substantial discretion to use utilization control techniques to steer Medicaid beneficiaries toward or away from certain drugs, within limits.…
- November 30, 2016
Fact Sheet: Medicaid Outpatient Prescription Drugs
Read morePrescription drug coverage is an important facet of the Medicaid program. Although an optional benefit, all states cover outpatient prescription drugs in their Medicaid programs.This fact sheet provides an overview of Medicaid outpatient prescription drug coverage, including: federal minimum requirements, state restrictions on prescription drug access, and special rules…
July 29, 2015Issue No. 5 – Pharmacy and Therapeutics Committees
Read moreIntroduced by the Affordable Care Act (ACA), Essential Health Benefits (EHB) are a set of ten health care service categories that plans must cover. One of the ten categories of benefits is prescription drugs. On February 20th, 2015, the Department of Health and Human Services (HHS) issued the Notice of…
July 29, 2015Issue No. 4 – United States Pharmacopeia Classification System
Read moreIntroduced by the Affordable Care Act (ACA), Essential Health Benefits (EHB) are a set of ten health care service categories that plans must cover. One of the ten categories of benefits is prescription drugs. On February 20th, 2015, the Department of Health and Human Services (HHS) issued the Notice of…
June 22, 2015EHB Prescription Drug Standard Issue No. 3 – Mail-Order Pharmacies
Wayne Turner and Shyaam Subramanian Issue BriefRead moreIntroduced by the Affordable Care Act (ACA), Essential Health Benefits (EHB) are a set of ten health care service categories that plans must cover. One of the ten categories of benefits is prescription drugs. On February 20th, 2015, the Department of Health and Human Services (HHS) issued the Notice of…
May 8, 2015EHB Prescription Drug Standard – Exceptions Process
Read moreIntroduced by the Affordable Care Act (ACA), Essential Health Benefits (EHB) are a set of ten health care service categories that plans must cover. One of the ten categories of benefits is prescription drugs. On February 20th, 2015, the Department of Health and Human Services (HHS) issued the Notice…